Alcohol is the main drug in South Africa with 30% of the population being either alcoholics or at risk of becoming so. According to WHO, South Africans drink in excess of five billion litres of alcohol per year. If that’s not bad enough, alcohol abuse tends to be a prerequisite to health problems, criminality and socio-economic burdens. But who is the abuser behind these statistics? And what can be done to prevent alcohol abuse?
Despite warning labels on alcoholic beverages, South Africans are hard drinkers. This shocking information goes some way to explaining why South Africa has the highest percent of children born with Foetal Alcohol Syndrome (FAS) in the world at 12.2%. Fighting alcohol abuse in South Africa would also help the fight against a number of health and social issues, which can often be exacerbated by alcohol dependency.
Alcohol abuse in South Africa can be traced all the way back to the arrival of the Dutch, who used alcohol to buy land from the natives, which eventually lead to the dop system, where labourers were paid in poor quality alcohol. The landowners wanted to make their workers addicted in order for them to stay on the wine farm. During apartheid it was illegal for non-European people to drink, which is why the shebeens started appearing in townships as a form of rebellion against the system – those who didn’t see drinking as a form of rebellion still abstain today.
The dop system was made illegal in the Western Cape in the 1960s, but wasn’t totally enforced until Mandela’s government. The final banning wasn’t implemented nationwide until 2003 with the Liquor Act declaring that ‘an employer must not supply liquor or methylated spirits to any person as an inducement to employment’. But the dop system isn’t over and done with yet. CEO and founder of FASfacts, Francois Grobbelaar says: ‘The legacy of the old dop system surely has a huge effect on the many vulnerable communities where it has been applied.’ The coloured farming communities in the Western Cape also have the highest rates of FAS in South Africa.
Even though culture and history have done their parts, alcoholism has something more to it: genes. Cathy Karrassellos, clinical psychologist at the Cape Town Drug Counselling Centre (CtdCC), says that when she meets with a client, it’s quite common to find a history of addiction within the family. ‘It’s not a 100% link, as you can become an alcoholic without the gene, but it’s definitely an indication.’
Unfortunately, children suffering from FAS are themselves at a very high risk of becoming addicted to alcohol or other drugs. According to Grobbelaar, they need lifelong intervention strategies and supervision in order to abstain from alcohol. ‘They are born with addictive personalities, due to prenatal exposure to alcohol with subsequent lifelong brain damage,’ he explains.
Many addicts blame their abuse on tragic life events, but that will never be the main reason according to Karrassellos, as other people with the same life experiences will be able to overcome trauma without an addiction. Life events can, however, push you faster down the road towards addiction if you have the predisposition. Even though the gene can be present in anybody, the life experiences connected to living in poverty might heighten the risk of becoming an alcoholic, compared to those with the gene living less impoverished lives.
Even though the CtdCC has more clients addicted to methamphetamine or dagga, alcohol is the most consumed drug in South Africa. It is also the only legal drug, which makes the it seem more acceptable to addicts and more often than not they abuse alcohol along with their main drug. The fact that alcohol is legal doesn’t mean it’s any less addictive and often people don’t fully understand this. A glass of wine on a night out is widely accepted by the population, and no one would be considered to be an alcoholic based on this.
However, Karrassellos always encourages her clients to abstain from alcohol, even though they aren’t abusing it when they begin their treatment at the clinic: ‘Their problem is not that they are a heroin addict, their problem is that they are an addict, so they will have a problem with any substance.’ The clients, who don’t abstain from alcohol after their treatment, will most often return to the clinic to undergo treatment again. Karrassellos explains that it is hard to educate abusers that alcohol is a drug, especially since it’s advertised in colourful, euphemistic commercials, where people are having a good time while drinking alcohol. Understandably, people think that alcohol is not harmful.
However, Karrassellos always encourages her clients to abstain from alcohol, even though they aren’t abusing it when they begin their treatment at the clinic: ‘Their problem is not that they are a heroin addict, their problem is that they are an addict, so they will have a problem with any substance.’
Abusing alcohol has further fatal health consequences for the consumer such as cancer, depression and dementia. These are serious sicknesses, especially because alcohol also lowers the immune system and weakens the body. However, it’s not only sicknesses directly developed by alcohol that are threatening to the addict. Karrassellos reports that the fight against alcohol abuse will aid the fight against HIV/AIDS, as any addiction, drugs as well as alcohol, puts you at a higher risk of getting HIV. This is due to two factors: first of all, your judgement is impinged while being intoxicated by a substance, which often leads to unprotected sex. Secondly, you tend to put yourself in dangerous situations when you are an addict. When visiting a drug dealer, you will most often find yourself in dangerous areas, where there is a high risk of rape or assault, and if you share needles with someone who has HIV, you can easily transfer the virus.
If you are infected with HIV, any drug abuse will shorten the period of time before it evolves into AIDS. Even though most alcohol and drug clinics don’t keep data on whether or not their clients have HIV/AIDS, clinics like CtdCC often offer free counselling and testing along with their treatment. Almost 10% of CtdCCs clients have at some point prostituted themselves in order to get money for drugs – a profession often leading to STDs, including HIV.
Alcohol abuse can also harm others, not just the consumer. A pregnant woman abusing alcohol is not only ruining her own health, but her unborn child’s as well. Children born from alcohol abusive mothers suffer from Foetal Alcohol Syndrome (FAS) which causes unchangeable brain damage and a predisposition to being an addict themselves.
Visually, some of the people suffering from FAS can be spotted by the smooth philtrum, meaning that the line between the nose and the upper lip is missing. They also tend to have a thinner upper lip and smaller eyes. However, it is the hidden damages that are the worst – the brain of a child or adult suffering from FAS is smaller than the brain of a person not suffering from FAS, making the brain damage permanent. There is no cure for FAS but you can prevent it by avoiding alcohol while pregnant.
It’s clear that something has to be done to combat the damages caused by alcohol abuse in South Africa. FASfacts are already running successful educational programmes to prevent alcohol dependency and their Experiential Learning Programme teaches Grade 6s and 7s about the risks of alcoholism. Mentors from FASfacts work in collaboration with family and friends close to pregnant alcohol users with the hope of precluding damage. These mentors offer valuable support, but the alcohol user must also want to change their habits. Education and awareness is essential in the fight against alcoholism.
Even though alcohol is legal, it’s still as much a drug as any other and even though it’s served at bars, clubs and social events it needs to be consumed sensibly. Advertising by the liquor industry often portrays how drinking enhances your life – showing scenes of young, happy people drinking. But there is definitely a ‘before’ and ‘after’ story with alcohol and these adverts will only ever show the ‘before’ montage. As with any addictive drug, be aware of the consequences and be responsible.
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